Active NPI
Alex Blake Jarrett, DDS
- General Practice Dentistry
- Redmond, WA
National Provider Identifier
1114126539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00010998
- Practice address
- 8105 166TH Ave NE
Redmond, WA 98052-3999 - Phone
- (425) 885-5119
- Fax
- (425) 882-0204
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00010998 | WA | Primary |
Addresses
Primary practice location
8105 166TH Ave NE
Redmond, WA 98052-3999
Mailing address
8105 166TH Ave NE
Redmond, WA 98052-3999
Phone (425) 885-5119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010998 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1114126539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8105 166TH AVE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980523999",
"telephone_number": "425-885-5119",
"fax_number": "425-882-0204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8105 166TH AVE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980523999",
"telephone_number": "425-885-5119",
"fax_number": "425-882-0204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARRETT",
"first_name": "ALEX",
"middle_name": "BLAKE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00010998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.